Padma Shri and Dr B C Roy National Awardee

According to a study presented at the American College of Cardiology meeting and published online in the Journal of the American Medical Association, by Dr Harry Selker at Tufts Medical Center, Boston, MA, individuals with symptoms of heart attack who were given a treatment containing glucose, insulin and potassium by paramedics were less likely to experience cardiac arrest, compared to patients who did not receive the treatment, although the treatment may not prevent patients from progressing to a heart attack.

In the trial, paramedics from 13 cities were trained to administer the solution after determining that an individual was likely having or about to have a heart attack.” Individuals “who received the solution immediately after being diagnosed with acute coronary syndrome…were 50 percent less likely to experience cardiac arrest or die compared to those who received the placebo.” The findings “were even more pronounced for people with more severe ST-elevation heart attacks.”

Prostatic artery embolization relieved the symptoms of benign prostatic hyperplasia in 2 studies presented at the Society of Interventional Radiology 37th Annual Scientific Meeting, San Francisco, California. The novel procedure, which has been tried in only 2 centers in the world, offers an alternative to transurethral resection of the prostate (TURP), with potentially fewer adverse reactions, said researcher Francisco Cesar Carnevale, MD, PhD, professor and chief of the interventional radiology section at University of São Paulo in Brazil, in a statement. [Medscape]

Levels of non–HDLC among users of statins is linked to the risk for a major cardiovascular event, such as a heart attack or stroke, more strongly than are levels of LDLC and apolipoprotein B. The finding, from a meta-analysis of data from 8 trials comprising a total of 62,154 patients, is published in the March 28 issue of JAMA by S. Matthijs Boekholdt, MD, PhD, from the Academic Medical Center, Amsterdam, the Netherlands.

The meta-analysis looked at individual-patient data from randomized, controlled statin trials published between 1994 and 2008. All study participants had conventional lipids and apolipoprotein levels assessed at baseline and at 1-year follow-up.

Among the 38,153 patients who were randomly assigned to statin therapy, 158 (0.4%) had a fatal myocardial infarction and 1678 (4.4%) had a nonfatal myocardial infarction during follow-up. Death due to other types of coronary artery disease occurred in 615 (1.6%) of the study participants, and fatal or nonfatal stroke occurred in 1029 (2.7%) study participants. In addition, 2806 (7.4%) patients were hospitalized for unstable angina, and 6286 major cardiovascular events (MACE) occurred in 5387 participants, for an event rate of 14.1%. The analysis showed that all the studied lipid and apolipoprotein measures were associated with the risk for MACE and that these associations were statistically significant.

Further analysis showed that the difference between LDL-C and non-HDL-C in predicting the risk for MACE for each 1–standard deviation increase was statistically significant (P = .002). The difference between non-HDL-C and apoB was also statistically significant (P = .02), but the difference between LDL-C and ApoB was not (P = .21).

Given the fact that many other arguments for the clinical applicability of non-HDL-C and LDL-C are identical, non-HDL-C may be a more appropriate target for statin therapy than LDL-C. [Source Medsacpe]